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PROVIDENCE HEALTH SERVICES
NPI 1942546858
Surgery in Washington, DC

Active since December 20, 2012
1160 VARNUM ST NE, DEPAUL 307, WASHINGTON, DC 20017(202) 854-4014(202) 854-4082 Get Directions Write a Review

NPPES record last updated: October 5, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Providence Health Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE HEALTH SERVICES (NPI 1942546858) is a healthcare organization registered as a surgery in Washington, District Of Columbia and active in the NPI registry since December 2012. The organization lists Beau Higginbotham, Cive President/coo, as its authorized official.

NPPES Registry Identity

NPI1942546858
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NamePHS GEN SURG DP307
Location Address1160 VARNUM ST NE, DEPAUL 307Washington, DC 20017-2107
Mailing Address1160 Varnum St Ne, St Catherine's Hall, Room 102Washington, DC 20017-2107 · (202) 854-4069 · Fax (202) 854-7825
Phone(202) 854-4014
Fax(202) 854-4082
Organization SubpartYesParent: Providence Hospital
Authorized OfficialBeau HigginbothamCive President/coo · (410) 368-3162
Enumeration DateDecember 20, 2012
Last NPPES UpdateOctober 5, 2017
✔ NPI 1942546858 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in DC · HFD01-0212
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedGeneral Acute Care HospitalTaxonomy 282N00000X · License HFD01-0212 (DC)
1160 VARNUM ST NE, Washington, DC 20017
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Other Names 1

Doing Business AsProvidence Health Services

Other Identifiers 4

Medicaid005145400MD
Medicaid09810714VA
Medicaid029833400DC
Medicare PIN090006

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. UCHENNA ANTHONIA OBICHERE CRNP
Nurse Practitioner (Psychiatric/Mental Health)
1160 VARNUM ST NE, SUITE 317
WASHINGTON, DC 20017
District of Columbia (202) 636-1130
PHS INTERNAL MEDICINE DP317
Internal Medicine
1160 VARNUM ST NE, DEPAUL 317
WASHINGTON, DC 20017
District of Columbia (202) 640-4837
YULIZA ABIGAIL LEMUS GAMES
Behavior Technician
1160 VARNUM ST NE
WASHINGTON, DC 20017
District of Columbia (202) 525-1448
ANITA KUNWAR MD
Internal Medicine
1160 VARNUM ST NE
WASHINGTON, DC 20017
District of Columbia (202) 854-7785
RESOURCE PHARMACY INCORPORATED
Pharmacist
1160 VARNUM ST NE
WASHINGTON, DC 20017
District of Columbia (202) 832-2200
PHS MULTISPECIALTY SERVICES
Surgery
1160 VARNUM ST NE, DEPAUL 300
WASHINGTON, DC 20017
District of Columbia (202) 854-4014
PHS INTERNAL MEDICINE DP311
Internal Medicine
1160 VARNUM ST NE, DEPAUL 311
WASHINGTON, DC 20017
District of Columbia (202) 854-4470
BRANDI DENISE FISHER
Behavior Technician
1160 VARNUM ST NE
WASHINGTON, DC 20017
District of Columbia (202) 525-1448

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phs Gen Surg Dp307's NPI number?

The NPI number for Phs Gen Surg Dp307 is 1942546858. It was assigned to this organization in the NPPES registry on December 20, 2012. The provider is doing business as Providence Health Services.

Where is Phs Gen Surg Dp307 located?

Phs Gen Surg Dp307 is located at 1160 Varnum St NE Depaul 307, Washington, DC 20017. The listed phone number is (202) 854-4014.

What is Phs Gen Surg Dp307's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

When was this NPI record last updated?

The NPPES record for Phs Gen Surg Dp307 was last updated on October 5, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.